A unique application of web 2.0 in Radiology (also known as Radiology 2.0) since 2004. Widely recognized and cited by various journals and magazines. One of the first mover in the world of Rad-blogging

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Thursday, September 27, 2007

This patient was referred to us for second opinion with clinical features of dystonia and non-specific initial MRI report. On MRI we noted bilaterally symmetric hyperintense signal changes in anterior medial globus pallidus with surrounding hypointensity in the globus pallidus on T2-weighted images. These imaging features are fairly diagnostic of HSD and have been termed the “eye-of-the-tiger” sign.The hyperintensity represents pathologic changes including gliosis, demyelination, neuronal loss, and axonal swelling, and the surrounding hypointensity is due to loss of signal secondary to iron deposition.

Germinoma and teratoma are two germ cell tumors that can arise from the pineal gland. Germinoma is the most common pineal tumor, accounting for 40-50% of all pineal region tumors and two-thirds of all germ cell tumors. It affects primarily children or young adults and is significantly more common in males. Germinomas have a homogenous appearance on MRI and enhance strongly following contrast administration. Teratoma accounts for 15% of pineal masses and also demonstrates male predominance. These lesions are heterogeneous with calcifications and mixed CSF, lipid and soft tissue areas. Germ cell tumors tend to engulf primary pineal calcifications.Pineal parenchymal lesions include pineocytoma and pineobalstoma. Pineocytoma is an enhancing lesion that affects adults. This benign entity is characterized by good demarcation, homogeneity, and slow growth. It is noninvasive. Pineoblastoma generally affects children and occurs with approximately equal incidence in males and females. Common characteristics of this malignancy include local invasion, distant CNS spread, heterogeneity, calcification, and marked enhancement. It is important to obtain images of the spine to look for metastases. Parenchymal tumors will have intrinsic calcifications, producing an exploded appearance .The above case is a lady young and homogenous enhancement hence pineocytoma is possible.The clinical presentation of a pineal lesion may include obstructive hydrocephalus, Parinaud's syndrome (characterized by palsy of upward gaze, dissociation of light and accommodation, and failure of convergence) caused by compression of the tectum, and endocrine abnormalities ( e.g., precocious puberty) in cases of germ cell tumors. One of the radiologist's main roles is to determine the origin of the lesion. Lesions arising from adjacent regions and extending to the pineal region include CNS lipoma, epidermoid, arachnoid cyst, astrocytoma, and meningioma. Lesions arising from the pineal gland itself include germ cell tumors, pineal parenchymal lesions, pineal cysts, vascular malformations, and metastases.

Wednesday, September 12, 2007

Gliomatosis cerebri (infiltrative diffuse astrocytosis) is a rare primary brain tumor. It is commonly characterized by diffuse infiltration of the brain with neoplastic glial cells that affect various areas of the cerebral lobes. Before the advent of MRI, diagnosis was generally not established until autopsy. Typically, gliomatosis cerebri appears as a diffuse, poorly circumscribed, infiltrating non-enhancing lesion that is hyperintense on T2-weighted images and expands the cerebral white matter. The prognosis for gliomatosis cerebri is generally poor, with a median survival time of only 12 months.

Wednesday, September 05, 2007

MRI is the study of choice for the diagnostic evaluation of arachnoiditis. T1-weighted MRIs may reveal an indistinct or absent cord outline due to the increase in the signal intensity of the surrounding CSF. T2-weighted MRIs may demonstrate CSF loculation and obliteration of the subarachnoid space or irregularly thickened, clumped nerve roots, which occasionally may be misinterpreted as a tethered cord or a thickened filum terminale. With more severe arachnoiditis, progression of nerve root clumping and leptomeningeal adhesions may lead to angular defects in the dural sac. Peripheral adherence of the nerve roots to the walls of the thecal sac produces the so-called featureless, or empty, sac.Case by-- Teleradiology Providers

After eliciting reader nominations and debating for hours, RT Image is proud to present the 2007 roster of radiology’s most powerful people, institutions and organizations. Whether their influence comes in numbers or from the dedication of one, all those on our list demonstrate the drive, character and integrity that deserve the title of “Most Influential.”Check out the number 24th for a mention of yours truly Dr Sumer Sethi and his experience with Rad-Blogging. I am proud that the concept of rad-blogging is now recognized as one of the 25 most influential in the world of Radiology.

About Me

Unique blend of academic excellence &entrepreneurship, heading leading firms in India- Teleradiology Providers, pioneering company providing teleradiology services and DAMS (Delhi Academy of Medical Sciences) Premier test preparation institute in India for MD/MS/MCI preparation. He has also been an invited faculty member at various conferences, including Teleradiology in IRIA 2008&2011, Hospital Build Middle East, Congress of the Brain Tumor Radiology in Neuro-oncology Society. Dr. Sethi is Editor-in-Chief of Internet Journal of Radiology. He has a keen interest in Web 2.0 technologies and in maintaining his famous radiology blog, which has been featured in multiple international journals. To date, Dr. Sethi is the author of approximately 50 publications,fifth edition of his book Review of Radiology is a best-seller among medical students. Comments and submissions to this blog are moderated by the webmaster. No comment or submission is possible before moderation. We in our weblog assume all users are by default considered as non medical professionals. We don’t encourage spam or misleading comments and such comments will be deleted; users may be banned after warning.

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